Surgical and examination table structure

ABSTRACT

An improved table structure capable of adopting various surgical operation positions as well as positions for X-ray and image intensifier examinations includes a base, a vertical supporting frame, carrier means pivotably mounted at the upper end of the supporting frame, and patient-receiving serially interconnected panels. Means are provided in the carrier means for longitudinally displacing the panels with respect to the supporting frame in such a way that a complete examination of a patient is possible without any need of moving him so that body areas ordinarily hidden to examination due to the structure of conventional tables may now be reached. The table structure also includes novel mechanisms for effecting various pivotal movements of the panels with respect to one another or with respect to the carrier means. Also provided is a novel manual control device for actuating the hydraulically operated parts of the table structure to achieve the various examination and surgical operation positions.

United States Patent 11 I Pageot et al.

1111 3,868,103 1451 Feb. 25, 1975 [75] Inventors: Jacques Pageot, Laval, Quebec;

Yvon Roy, Saint Leonard, Quebec; Cesar Purkhardt, Ste-F0)! Quebec, all of Canada [73] Assignee: Millet Roux & Cie., Ltee., Laval,

Quebec, Canada 22 Filed: Apr. 24, 1973 21 Appl. No.: 354,111

[52] US. Cl 269/325, 74/222, 137/596 [51] Int. Cl A6lg 13/00 [58] Field of Search 5/62, 66-69;

Primary Examiner-Granville Y. Custer, .lr. Assistant Examiner-Neil Abrams Attorney, Agent, or FirmCushman, Darby & Cushman [57] ABSTRACT An improved tablestructure capable of adopting various surgical operation positions as well as positions for X-ray and image intensifier examinations includes a base, a vertical supporting frame, carrier means pivotably mounted at the upper end of the supporting frame, and patient-receiving serially interconnected panels. Means are provided in the carrier means for longitudinally displacing the panels with respect to the supporting frame in such a way that a complete examination of a patient is possible without any need of moving him so that body areas ordinarily hidden to examination due to the structure of conventional tables may now be reached. The table structure also includes novel mechanisms for effecting various pivotal movements of the panels with respect to one another or with respect to the carrier means. Also provided is a novel manual control device for actuating the hydraulically operated parts of the table structure to achieve the various examination and surgical operation positions.

13 Claims, 32 Drawing Figures PATENIED FEBZS i975 sum OBUF 10 v N8 3m 9m Q: OMNJ wmm wmw PATENTEU F5325 I975 SHEET 08 0F 10 mmmJ o SURGICAL AND EXAMINATION TABLE STRUCTURE BACKGROUND OF THE INVENTION 1. Field of the invention This invention relates to a table structure for use in surgical operation, X-ray examination and image intensifier examination. More particularly, the invention relates to a table structure for use in major operations where, in addition to surgery, X-ray examination and- /or image intensifier examination are required.

2. Description of the Prior Art Presently available image intensifierexamination apparatus, for example, consist of a bifurcated arm in the form of either aC or a U, at one end of which is mounted an image intensification tube positioned over the table top on which is placed a patient to be studied and at the other end of which is mounted a coacting mechanism mounted in the path of the beam of rays emitted by the tube through an area of the body. The arm is constructed so thatthe tube may move horizon tally, vertically and rotatably relative to the table top. The vertical supporting frame of conventional tables, however, hinders a complete horizontal examination of the patients body due to the presence of crossmembers and mechanical linkages. it is frequently required to move the patient after a first examination so that a complete examination of all or other areas of the body may be conducted. When a patient is either seri ously injured or critically ill, the movement may be painful and detrimental to his health.

SUMMARY OF THE INVENTION According to the present invention, an examination and surgical table is so constructed as to enable a longitudinal displacement of the table top relative to the table vertical frame whereby the opposite ends of the means are capable, of, relative tilting movements relative to one another thereby adopting various surgical and examination positions which are required during either an X-ray examination, an image intensifier examination, or during surgery.

Another aspect of this invention is a novel mechanism for articulating the leg panel or the back panel relative to the intermediate trunk panel. This mechanism includes at least one elongated housing fixed to a first panel; a pair of spaced parallel transverse axes mounted at opposite ends of the housing; sprocket means mounted on each axis; chain means entrained around the sprocket means, the chain means defining opposite intermediate strands extending between the sprocket means; toothed wheel means mounted on a first of the transverse axes; hydraulic drive means mounted in the housing and including a cylinder and a piston having one end received in the cylinder and the other end fixedly attached to one of the intermediate strands; a third transverse axis transversely mounted to the housing in the vicinity of the first transverse axis comprises: a base; 'verticaltsupporting frame means fixed. at one end thereof, to the base; a carrier means slidably mounted to the supporting frame means at the other end thereof; platform means mounted on the carrier means to support a patient and including a head panel, a back panel, a trunk panel and a leg panel, said panels being serially connected; and drive means mounted to the supporting frame means at said other end thereof for slidably displacing inthe longitudinal direction the carrier means relative to the supporting frame means; the longitudinal displacement of the carrier means being such that all points on the platform means have at one time or another a vertical axis which clears the supporting frame means to thereby facilitate an examination of a patient on said platform means without moving the patient during the examination.

In addition to be capable of longitudinal displacement, the table structure described herein is also capable of various positions. For instance, the platform means and carrier means may be raised and lowered, tilted sideways,.frontwardly or rearwardly. Furthermore, the individual panels defining the platform and adapted to receive thereon a toothed portion of a second panel for meshing engagement with the toothed wheel means whereby torque received on the first transverse axis through actuation of the chain means by the hydraulic drive means is transmitted from the toothed wheel means to the toothed portion of the second panel to thereby cause pivotal movement of the second panel relative to the first panel.

The table structure made in accordance with the present invention also includes a novel mechanism for tilting, in opposite directions, the intermediate trunk panel to provide various angled positions between the platform means and the carrier means. During a surgical operation, it is often required to change the normally horizontal position of the patient-receiving platform means to angles varying from [50 to 210.

The novel tilting mechanism comprises: at least one elongated housing mounted in the carrier means and including a bottom wall and opposite side walls, an elongate drive plunger longitudinally displaceable in the housing centrally thereof; drive means for displacing the plunger in the housing; a pair of identically shaped elongated linking members V respectively mounted in the housing on opposite sides of the drive plunger; each linking member being pivotally mounted at one end thereof to a transverse axis secured to an adjacent side wall of the housing, the transverse axes of the linking members being parallel and longitudinally spaced in the housing; each linking member being provided with an elongated curved slot; the drive plunger including, on each side wall thereof, a projection means extending into an associated slot of the linking members, plate means extending longitudinally over the housing and having one end pivotally connected to one linking member at the end thereof opposite the end pivotally mounted to a side wall of the housing and having the other end pivotally connected to the other linking member at the end thereof opposite the end pivotally mounted to the other side wall of the housing; the slot being shaped whereby the longitudinal displacement of the plunger in the housing by the drive means and the resulting travel of the projection means in their respective slots cause the following positions: a first position where a first linking member is pivotally inclined relative to the plane of the housing, a second position where both linking members are received in the same a third position where the other linkingmember ispivotally inclined relative to the plane of the housing and plane asthe plane of thehousingand the plungereand; V r

FIG is an elevational longitudinal View showing part of the platform mea'ns in pivotal movement rela- 1 V tive to the supporting frame; t

in opposite direction relative to the first position, the

linking members entrainingthe plate means in identical positions. t c L V The actuation of'all movable parts of the table struc- Thehydraulic manual control device comprises: a

J housingra fluid input line and a fluid return line re,- ceived in the housing, the'fluid in the input line being j under pressure; atseries of cavitiesvertically,extending t I in the housing; actu-atablepiston meansreeeived'in "each of the cavities, including a piston theaddividing" 'ture of'the present invention is hydraulicallycarried ,r out by means of cylinders andpistons. A novel manual 7 device has beendevised toremotely'Commandrand r control the various movem e nts of the structuralparts of the table structure. r r 4 the cavity into first and second, chambers respectively, i

disposed on either side of the pistonhead; a'first series of channels interconnecting the fluid input linewith the first chambers; 21 second series of channels intercone necting the fluid return line with the second chambers; and a third series of channels extending in :thehodsing and received in thecavities vertically between the first series of channels and the secondseries of channels,

the channels of the third series adapted to be opera 7 V tively connected to hydraulic drive means for each of the movable parts of the table; each channel of the second series being in communication; via an "associated t second chamber, with a related channel of thethird series when the associated piston head isin a normalfres't positionin the cavity; each c hannel of the first series being in comminication, via an, associated first c hamber, with a related channel of thethird series when; the

associated piston head is depressed in the cavity" wherebyrdepression of atpistonhead allowsfiuid pres sure to be transmitted from the first chamber to an ,associated channel of the third series to cause the actua tion of a movable part of the table. a

' BRIEF oEscRiPTroN or rneonnwmos Other objects purposes and charac-t'eristic features of the present invention will be in part obvious from the FIGHl is aside perspective view illustrating asurgi cal' operation and examination table structure made in ac:

cordance with the presentinvention;

FlGSn2 -ll represent various movements made possible with the table structureof FlQql; I i

7 FIG. 12 is an elevational view, partly broken away, 7

taken along lines 12-l2 of FIG. s and principally rep;

"resenting the vertical supportingframe; v

FIG. '13 is a plan crosssectional view taken along along lines 14-14 of FIG. 13; c

FIG. 15 is a plan cross-sectional view taken along FIG. 16 is a toppersp ective view illustrating the cou V pling member used at thc upper end of thes'upporting" fram c "parts," a tilting mechanism used withthe present table of thetable structure;

' 'FlGi. :18 is a transverse cross-sectional viewshow ing thefplatform means in pivotal movement relative to the fsupportingframe';

FIG, 19 is a side cross-sectional lines 'l9- 19 0f FlGnll j FIGIZO is a side cross-sectional view taken along lines 2o 2o armors;

FlG. 2i isa'bottom view oftther nechanismshown in F1620; 7' r Fio. 22 is an enlargedsideiviewshowing the pivotal' I overnentfof a leg panel relative to thegtrunlc panelof I FIG. fisaside perspective, view showing the connection between one extremity of, th'erleg panel and its coupling attachment member to the trunk panel;

' FIG. 24 isa topa top view showing,lin broken parts,

the mechanism illustrated in P16310423;

FIGWZS is aperspective' view showing; in broken structure;

" FlGSjQfi and 27areschematicl diagran isrepresenting twoinclined positions iofthe tiltingJmechanism;

I yFIGt 28ris a schematic diagrarntoftthe hydraulic cir-- cuitry to operate thedifferent movable parts of the table structureflj T V I i 7 V RG29 isa side perspective view of a manual control device used for thea'ctuationof the hydraulic circuitry V "FlGy30 is a1transverse"cross-sectional view taken FIG. 31 is a longitudinal cross-sectionaltview taken FlGq32is a longitudinal CI'QSS-SGCUOHEiiViQW taken along Jihes32-32 of Frost);

I GENERAL I k Referring to FIG. l olfthe drawingsan examination and surgicalfioperation table structure 100 generally I comprises patient-receiving platform means 102 which consist of'four serially interconnected panel' sections,

namely a head panel 104; a back rest panellhfi, an, in- I termediate trunk panel 103 and aleg panel lit thelatter being preferablyin twosections. These panels are 1 adapted for fluoroscopic examinationand radiography dinally;displaceable over verticallsupporting frame i i 'purposesifand are'madeof Bakelite orother satisfactory i c materialtsuitably permeableyto X-rays. The platform means 102 are supported on carrier means 112 longitu "means 111.4 mountedon a base lltr.

c FIG/141s a'transverse cross-sectional view tak enfl '7 108a, andarta eachprovidedwithdownwardly and long i V 'gitudinally extending siddgfissucih as lll6b',-lll)8bt This panel construction allowstthe insertion ofaczrs-l setteortother type of diaphragm beneath the panels Referring'to FIGS.,2-1l, thereare shownsorne of the 7 various positions in which the table structure lllfli'm-ay j be moved, Referencei will be made to; these figures as theidescription oftherdifferent Ycor nponentsof the table,

structure progresses. t

1 Referring to F1012 pa s r twojpanels tenancies I V are shown and arehingeclly connectedxat 109. All panv elsare somewhat similarly/iconfigurated in that they include a; flat horizontal top surface, such as 106a,

when theytable is used for radiography" purposes.

view taken along The vertical supporting frame means 114 includea cover 118 surmounted' by a bellow 120, both enclosing housings 122 and 124. Housing 122 has its lower end fixed to the base 116 and its upper end opened to telescopically received therein housing 124 to the upper end of which is pivotably connected the carrier means 112, as described below. Housings 122 and 124 receive therein hydraulically operated cylinder 126 and piston 128, one end of the piston being received in the cylinder while the other end is attached to the upper end of the housing 124 (not shown).

On base 116, within the enclosure 118, is mounted the hydraulic drive unit that includes a pump 130 and a series of valves, two of which are shown as 132.-The pump may be electrically operated or, in a case of a power failure, may be converted tofoot actuation by means of a foot pedal 134 which projects outside the cover 118 through an opening 136. For clarity purposes, the different fluid lines connecting the pump, the valves and the respective cylinders operating the various parts of the table structure have not been shown, except for fluid line 138 which serves in the actuation of respective cyliniders operating the variouos 128 in and out of cylinder 126 thereby raising and lowering the table structure relative to the base 116, as illustrated in FIG. 3.

The frame means 114 are connected to the carrier means 112 by a transversely extending plate 140 and a coupling member 142, the plate and the coupling memher being pivotally mounted to each other. The coupling member has a pair of ears 144-145 (FIG. 16) be tween which is received, for pivotal connection, by means of pin 146, a downwardly extending lug 147 of the plate 140 (FIG. 12).

Fixedly secured to the undersurface of plate 140 by means of brackets 148, 149, 150 and 151, FIG. 13, are two cylinders 152 and 153, each traversed by a pair of piston units 154-155 and 156-157, respectively. The opposite ends of the piston rods are fixedly secured to adjacent longitudinally extending housings 160 and 162 by means of lugs 163-164 and 165-166, respectively. The assembly of piston rods 154 to 157, lugs 163 to 166 and housings 160 and 162 forms the carrier means 112 which support and carry the platforms means 102. The cylinders 152 and 153 being fixedly mounted to plate 140, pressurized fluid introduced simultaneously at either appropriate ends (see port 167 in FIG. 19) of these cylinders causes the longitudinal displacement of the piston units relative to the cylinders.

Coupling member 142 is pivotally mounted at the.

upper end of the housing 124 by means ofa pair of lugs 167, 168 and a pin 170 extending through these lugs and through the housing 124. Member 142 further includes a pair of arms 172 and 173, FIG. 16, fixedly secured to a side edge 175 thereof and receiving therebetween a cylinder 174 pivotally attached thereto at its lower end by pin means 176. A piston 178 having one 6 194,16 integral with the coupling member 142, FIG.

An important feature of the present invention is that the table is constructed so as to allow a longitudinal displacement of the platform means so that, for example, the opposite ends of C-shaped image intensifier may be conveniently travel along these platform means and an examination of the patient is made possible over the entire body without the need of displacing the patient.

To achieve this, the longitudinal displacement of the platform means is made so that all points of the platform means may vertically extend at one time or another outside the veritcal supporting frame means 114.

A longitudinal displacement of the platform means consists in introducing through appropriate fluid lines (not shown) pressurized fluid in cylinders 152 and 153, which action causes the displacement of piston units 154-155 and 156-157 in and out of their respective cylinders. Since the piston extremities are attached to their respective housings 160 and 162 by means of lugs 163 to 166, the platform means, which are attached to these housings by plate 332, are also displaced longitudinally. .Comparing FIGS. 12 and 2, a point P arbitrary chosen in FIG. 12 as extending axially and centrally over the vertical frame means 114, may be longitudinallly displaced to a point where a vertical axis extending through this point completely avoids the enclosure 118-120 of the frame means 114. Hence, a complete examination of a patient is possible. As shown in FIG. 13, the cylinders are provided at opposite ends thereof with fluid conduit lines 152, 152", 153', 153"; depending on which side pressurized fluid is received in these cylinders, the direction of the displacement of the carrier means will either be to the right or to the left.

The pivotal movement of the carrier means in the longitudinal direction of the platform means, as shown in FIG. 4, consists in introducing pressurized fluid in cylinder 174 whereby the actuation of piston 178, FIG. 12, causes the pivotal movement, about pin 146, of plate 140 relative to the coupling member 142. Deviations of up to 35f with the horizontal plane have been obtained with a table structure made in accordance with the present invention.

The transverse pivotal movement of the table, as shown in FIGS. 5 and 7,is caused by the actuation of piston 187 in and out of cylinder 186 thereby pivoting pivotally mounted through pin 192 to a pair ofcars plate 140, and the platform means. 102, about pin 190 (FIG. 18). Deviations of up to 25 with the horizontal plane have been obtained with a table structure made in accordance with the present invention.

HINGE MECHANISM FIGS. 20-24 illustrate a mechanism for articulating one panel of the platform means 102 with respect to another panel, as illustrated in FIGS. 6, 7, 10, 11.1n the embodiment shown, the mechanism enables the articulation of a leg panel relative to the trunk panel 108 and the articulation of the back rest panel 106 relative to the trunk panel 108. V

The trunk panel 108 includes along opposite sides thereof (FIG. 18) two elongated housings 202, 204 respectively extending over housings and 162 of the carrier means 112; they also form the sides 108b of the trunk panel 108. Both housings 202, 204 are identically shaped and include the same hinge mechanism described hereinbelow. Each housing includes two opposite side walls 206,208 and atop wall are fixedly Se on which are respectively mounted'for rotation sprockets2lfi and 218. Entrained around these sprockets is a chian 220 which has one'iintcrme diate strand 222 is fixed to a block 224. A piston 226 has one end fixed to the block 22f4, the. other end thereof being received in a cylinder 228Jrwhich,in turn, is fixedly mounted in housing 202. A pair of gear wheels 230 and 232 are mounted on axis 214m either side ofth'e sprocket 218;

A third axis 234% extends transversely of the housing s l and; is fixed to the opposite side walls d and 208" thereof. Each leg panel 110 is pivotally connected on this airis 234 by means of acou pling attachmentt236- which has two projections '238 and 240, respectively provided with a toothed portion 242,: 244 adapted to mesh with a corresponding gear wheel 230, 232.

the rotation of the chain 220 around" sprockets 2l6ancl 218; the gear wheels 230,232 are thus rotated causing similar rotation of the coupling attachment 2360f the a r leg panel 110. t w V A similar mechanism may be installed in the side edges 10612 of the back restfpanel 106 to effect relative 1 V movement of'the back rest panel relative to thetrunk panel H0. An adapter block 246 is fixed to the side walls 206'and 208 of the housing 202. The block has two projections 238' andq240l respectively provided with toothed portions 242,; 244" mounted on atransverse axis 234'v mounted to the side walls 248 and 250 to the side wall 304 of thehousing bymeans of'a pin l linking memberrfvli llispivotallymounted at one l endthereof to the side wall 305 byrneans of pin 32s. The opposite end oflinkin'g member 312 is 'pivotally n jrriounted to atIplate s332bywmeans of apin SZtieXtendr j ingjthrough an ear '330locat'ed-at3one en'dofithe plate, The opposite end of linking'member 3M is pivot-ally mounted to'plate 3312b means of a pin 336 extending through an ear ass 'locatedgat the other end of plate.

Anappropriategroove 337Yin wull 305;;re'ceivesear 334 while car'330'is reeeiyedin housing 302m the same 3 plane as the plane of the plunger 3l'0ibetween linking Plunger-310k actuated longitudinally inthe l60bymeansofalhydraulically operatedcylinder 338 fixed to'the walls of the housingrandis connected thereto by a piston 340. a

v r 7 nos. and 2v6iiiustrate plate 332 in aninclined po- The articulation of a leg panel 110 relative to, the 7 housing 202 consists in introducing pressurized fluid in cylinder 228 therebyiactuatingpiston 226which causes, t

sitioni The operation of the tilting mechanism will be that housings 160 and :1 62, whichform part of the car a of the partially shown housing of the side edge'106b.

Theseitoothed portions 242, 244" mesh with corre sponding gear wheels 23'0" and 23 2;

The operation of this articulating mechanism is similar to the one described for housing 202. The introduc tion'of a pressurized fluid ina cylinder 228" results in the rotation of the chain 220 as well [as that of gear 7 wheels 230", 232'. Since trunk panel 108 isfixed to the carrier means 112, actuation ofthe articulatingmechat merit of the back panel relative to the fixed trunk panel.

rit'rino MECHANISM sion of a tilting mechanism for the trunk panel relative housings 160, 162 vertically disposed beneath housings 202, 204, respectively, of the hinge mechanism (FIG; 14), Referring to 16.25, each housing includes oppo-l site side walls 304, 305 and a botto mwall3'06i. The top ofthe housing has an opened portion 307 and a closed covered portion 308. Extendinglongitudinally in the" opened portion 307 of the'housing are'three elongate members 310,312 and 314 disposed in parallelrelationship to one another and in close proximity. The centrally disposedlmember' 310 is a plunger having a flat rectangular-shaped portion provided on "eachside face thereof with an outwardly extending projection in the form of a'pin 316, 318. These projections are received in corresponding curved slots 3-20 and 322'pr0- vided in linking members 3E2 and 314, respectively.

nism of back panel itiore'sults in the articulation move-s4 rierrneans and therefore may pivot longitudinally and ytransversely,'will be considered in a horizontal'positionj Pressurizedffluid introduced in cylinder'338 ca'uses the longitudinal displacement of. the plunger atom the at V rection opposite tothat shown by'arr'ow 342(Pin 316 a slides-to,the'-'left in slot 320ttsimilarly;pin 3-ll8rslidefls to the left along theccurved'surfaces of slots322. Linking I v member 314 pivots about pin 326 in aclockwise direc-j,

tion. Since slot 320 hasia horizontalp ortion 3201i, linltt ing memb'er'3l2 remains in a horizontal position inside i the housing while jtheplunger is movingstowards the 'lcftfwhfinpin 318 reaches the junction of the curved portion322c'and the'straight portion 322k all three. members 310, 312, 314 are ina horizontal plane and parallel to each otherJln this position, the plate 332 is also'in'a horizontal position and isin the prolongation 320i: of Slot320thereby pivoting plate 312 in a Clock wise direction about pin -324. At the 'sametime, pin 318m on the plunger travelsin the horizontal portion of slot 7 r 322k of link member 314;-henceiinlt member 314 remains in the horizontal plane of the housing and paral- L l lel to the plunger. The pivoting of, link member 312 oausesits upper edge 3E3 to contact the undersjurface V of plat e'332 which,,- in turn, pivots also in aclockwise,

direction'aboutpin 336. '7 I i 2 HYDRAULIC SYSTEM 1 V FlG. 2 8 "is a representative diagram of anhydraulic circuitry which can be used to assist in the operation-of a I the different movable mechanisms described I above.

I Fluid is pumped, for example,'from a reservoir R by means of a pump l30fwhich may be electricallyoper-l r ated or, inl a case of a powerufailureyfoot operated; Pressurized fluidis then directed to a series of pilotoperated four-way valves 402 -409which are adapted uto take three positions. The actuation of' each of these valves iseffec'ted by operating amanualicontrol device V 410 which is connected to the hydraulic pump and reservoir by means of a pressure reducing valve 412, a

fluid inputline li d and afluid return line are. The ac-' s tua'tion of a (valve by thecontrol device illfliresults in' the operation of a cylinder associated therewith. Each cylinder has been described above in connection with the operation of one or more parts of the table structure. For example, the actuation of valve 402 may result in the operation of cylinder 126 which was described above as causing the lowering and raising of the platform means. It is expected from the man skilled in the art to modify the arrangement of these cylinders to achieve other various movements; for example, two cylinders 228 may be arranged in parallel to effect the longitudinal displacement of the carrier means in two directions. A valve or restriction 418 in the main return line 420 is preferably provided to smoothen out the various operations of the cylinders.

The manual control device 410 is an important feature of the present invention and is shown in FIGS. 30-33. The device 410 includes an elongated housing 422 filled with a solid material 424 in which is practiced a series of fluid lines extending longitudinally and transversely of the housing. A series of cylindrical chambers 426, arranged in pair and disposed longitudinally of the housing, are also provided therein with finger operated pistons 428. The head 430 of each piston divides each chamber 426 into an upper portion 426a and a lower portion 426A series of channels 432, 433 connect the fluid input line 414 with the chambers 426 while another set of channels 434, 435 connect the fluid return line 416 with the same chambers 426. Channels 432, 433 are always in communication with the upper portion 426a of a chamber while channels 434, 435 are always in communication with the lower portion 426 of a chamber. A third series of channels 436. 437 connect the chambers with the four-way valves schematically represented as 402-409 in FIG. 28. These channels 436, 437 are in communication another either the upper portions of the chambers or with the lower portions thereof depending on the position of the piston head 430 therein. A spring 438 is received in each chamber between the piston head 438 and the bottom wall of the chamber to automatically return the spring to its rest position. Depression of the piston 430 against the spring 431 allows pressurized fluid to flow from channels 432, 433 to corresponding channels 436, 437, and to the associated four-way valve. When the piston, under spring action, is returned to its normal rest position, the associated valve causes the return of the fluid therein, via channels 436. 437 to corresponding channels 434, 435.

The valves 402-409 will not be described in detail since it is expected from the man skilledin the art to know of their construction and operation.

Although the table structure has been described above in relation to various aspects, it is believed that it may be further refined and modified in various ways. It is therefore wished to have it understood that the present invention is not limited in interpretation except by the terms of the following claims.

We claim:

1. A surgical and examination table structure capable of longitudinal displacement in opposite directions comprising: a base; vertical supporting frame means fixed at one end thereof to said base; carrier means slidably mounted to said supporting frame means at the other end thereof; platform means mounted to said carrier means for supporting a patient and including a head panel, a back panel, a trunk panel connected to said carrier means along the side edges of said trunk panel and at least one leg panel, said panels being serially connected; hydraulic drive means including at least one hydraulic cylinder fixedly mounted on the vertical supporting frame means at said other end thereof and having a piston member connected to said carrier means for slidably displacing in the longitudinal direction said carrier means relative to said supporting frame means; the longitudinal displacement of the carrier means being such that all points on the platform means have at one time or another a vertical axis which clears the vertical supporting frame means thereby permitting an examination of a patient positioned on said platform means without moving the patient during the examination and tilting means in said carrier means for pivotably moving said platform means relative to said carrier means.

2. A surgical and examination table structure capable of longitudinal displacement in opposite directions comprising: a base; vertical supporting frame means fixed at one end thereof to said base including vertically upstanding housing means, a coupling member pivotably connected to the upper end of said housing means and a plate means pivotably connected to the coupling member; carrier means slidably mounted to said supporting frame means at the other end thereof; platform means mounted to said carrier means for supporting a patient and including a head panel, a back panel, a trunk panel and at least one leg panel, said panels being serially connected; and hydraulic drive means supported by said plate means including at least one hydraulic cylinder fixedly mounted on the vertical supporting frame means at said other end thereof and having a piston member connected to said carrier means for slidably displacing in the longitudinal direction said carrier means relative to said supporting frame means; the longitudinal displacement of the carrier means being such that all points on the platform means have at one time or another a vertical axis which clears the vertical supporting frame means thereby permitting an examination of a patient positioned on said platform means without moving the patient during the examination.

3. A table structure as defined in claim 2 further comprising hydraulic drive means mounted between said housing means and said coupling member for causing transverse pivotal movement of said platform means relative to the longitudinal plane thereof.

4. A table structure as defined in claim 2 further comprising hydraulic drive means mounted between said housing means and said plate means for causing longitudinal pivotal movement of said platform means relative to said housing means.

5. A table structure as defined in claim 2 wherein said drive means consist of a pair of hydraulic cylinder and piston units respectively disposed along each side edge of said trunk panel; the cylinders of said unit being attached to said plate means; the pistons of said units being fixed to said side edges whereby the introduction of pressurized fluid in said cylinders causes the longitudinal displacement of said side edges relative to said cylinders.

6. A table structure as defined in claim 2 wherein said vertically upstanding housing means include first and second hollow housings telescopically received in one another, and hydraulic drive means mounted in said housings for lowering and raising said platform means.

trunk panel; each housing including a bottom wall and,

opposite side walls; an elongated drive plunger longitudinally displaceable in each housing centrally thereof; hydraulic drive means in each housing for displacing said plunger therein; a pair of elongated linking mem bers respectively mounted in each housing on opposite sides of said drive plunger, each linking member being pivotally mounted at one end thereof to a transverse axis secured to an adjacent side wall of said housing, the transverse axes being parallel and longitudinally spacedin said housing; each of said linking members being provided with an elongated curved slot; said plunger including on each side wall thereofa projection extending into an associated'slot in said linking members; plate means extending longitudinally over said housing and having one end pivotally connected to one linking member at the end thereof opposite to the end pivotally mounted to aside wall of the housing and having the other end pivotally connected to the other linking member at the end thereof opposite the end pivotally mounted to the side wall of the housing; said slots being shaped whereby the longitudinal displacement of the plunger into the housing by said hydraulic drive means and the resulting travel of said projection in said slots cause the following positions: a first position where a first linking member is pivotally inclined with respect to the plane of the housing; a second position where both linking members are received in the same plane as the plane of thehousing and the plunger; and a third position where the other linking member is pivotally inclined with respect to the plane of said housing,

and in opposite direction relative to the first position.

8. A surgical and examination table structure capable of longitudinal displacement in opposite directions comprising: a base; vertical supporting frame means fixed at one end thereof to said base; carrier means slidably mounted to said supporting frame means at the other end thereof; platform means mounted to said carrier means for supporting a patient and including a head panel, aback panel, a trunk panel and at least one leg panel, each trunk panel including along each longitudinal side edge thereof means for articulating a respective leg panel thereto; each said articulating means including an elongated housinglsecured to said trunk panel along said side edge; a pair of spaced parallel transverse axes mounted at opposite ends of the housing; sprocket means mounted on each said axis; chain means entrained around said sprocket means, said chain means defining opposite intermediate strands extending between said sprocket means; toothed wheel means mounted on a first of said transverse axes; hydraulic drive means mounted in said housing and including a cylinder and piston, said piston having one end received in said cylinder and the other end fixed to one of the intermediate strands, a third transverse axis transversely mounted to said housing in the vicinity of said first transverse axis and adapted to receive thereon a toothed portion of said leg panel for meshing engagement with said toothed wheel means whereby torque received on said first transverse axis through actuation of said chain means by said hydraulic drive means is transmitted from said toothed wheel means to the toothed portion of the leg panel to thereby cause pivotal movement of the leg panel relative to the trunk panel, said panels being serially connected; and'hydraulic drive means including at least one hydraulic cylinder fixedly mounted on the vertical supporting frame meansat said other end thereof and having a piston member connected to said carrier means for slid-r ably displacing in the longitudinal direction said carrier means relative to said supporting frame means; the ion-i gitudinal displacement'of the carriermeans being such that all points on the platform means have at one time or another a vertical axis which clears the verticalsupporting frame means thereby permitting an examination of a patient positioned on said platform means without moving the patient during the examination,

9. A table structure as defined inrclaim 8 further comprising second articulating means'mounted in each longitudinal side edge of said backpanel for causing pivotal movement of said back panel relative to said trunkpanel; each'said secondarticulating means including:

an elongated housing secured to said longitudinal side edge ofsaid back panel; a pair of spaced parallel transverse axes mounted at opposite ends of said housing; sprocket means mounted on each said axis; chain means entrained around said sprocket means, said chain means defining opposite intermediate strands extending between said sprocket means; toothed wheel means mounted on a first of said transverse axes; hydraulic drive means mounted in said housing and including a cylinder and a piston, said piston having one end received in said cylinder and the other end fixed to one of said intermediate strands; a third transverse axis transversely mounted to said housing in the vicinity of said first transverse axis; each elongated housing of said first articulating mean includinga block fixedly secured to said housing of said articulating means adjacent a second of said pair of transverse axes of said first articulating means; said block provided thereon with a toothed portion to be meshed with the toothed wheel means of the second articulating meansin said back panel whereby actuation of the drive means of the second articulating means in i and one leg panel, a device for articulating a first panel relative to a second panel comprising, incombination:

' at least one elongated housing secured to a first panel of said platform means; a pair of spaced parallel transverse axes mounted at opposite ends of said housing; sprocket means mounted on each said axis; chain means entrained around said sprocket means, said chain means defining opposite intermediate strands extending between said sprocket means; toothed wheel means mounted on a first of said transverse axes; hydraulic drive means mounted in said housing and including a cylinder and a piston, said piston having one end received in said cylinder and the other end fixed to one of saidintermediate strands; a third transverse axis transversely mounted to said housing in the vicinity of said first transverse axis and adapted to pivotally receive thereon a toothed portion of said second panel of said platform means for meshing engagement with said toothed wheel means whereby torque received on said first transverse axis through actuation of said chain means by said hydraulic drive means is transmitted from said toothed wheel means to the toothed portion of the second panel to thereby cause pivotal movement of the second panel relative to the first panel.

11. In a surgical table structure, as defined in claim 10, said first panel is said trunk panel and said second panel is a leg panel.

12. In a surgical table structure, as defined in claim 11, a second similarly constructed articulating device provided in said back panel; the elongated housing of the articulating device in said trunk panel including a block fixedly secured to said housing adjacent the second of said pair of spaced transverse axes; said block having thereon a toothed portion to be meshed with the toothed wheel means of the second articulating device in said back panel whereby actuation of the drive means of the second articulating device in the back panel causes pivotal movement of the back panel relative to trunk panel, and actuation of the drive means of the articulating device in the trunk panel causes pivotal movement of the leg panel relative to the trunk panel.

13. In a surgical table structure having a trunk panel, vertical supporting frame means and carrier means slidably mounted to the supporting frame means, a mechanism for tilting the trunk panel in opposite directions with respect to the carrier means comprising: at least one elongated housing mounted in the carrier means and including a bottom wall and opposite side walls; an elongate drive plunger longitudinally displaceable in said housing centrally thereof; drive means for displacing said plunger in said housing; a pair of elongate link ing members respectively mounted in said housing on opposite sides of said drive plunger, each linking member being pivotally mounted at one end thereof to a transverse axis secured to an adjacent side wall of said housing, the transverse axes being parallel and longitudinally spaced in said housing; each of said linking members being provided with an elongated curved slot; said plunger including on each side wall thereof a projection means extending into an associated slot of said linking members; plate means extending longitudinally over said housing and having one end pivotally connected to one linking member at the end thereof opposite to the end pivotally mounted to a side wall of the housing and having the other end pivotally connected to the other linking member at the end thereof opposite the end pivotally mounted to the side wall of the housing; said slots being shaped whereby the longitudinal displacement of the plunger in said housing by said drive means and the resulting travel of said projection means in said slots cause the following positions: a first position where a first linking member is pivotally inclined with respect to the plane of the housing; a second position where both linking members are received in the same plane as the plane of the housing and the plunger; and a third position where the other linking member is pivotally inclined with respect to the plane of said housing and in opposite direction relative to the first position. 

1. A surgical and examination table structure capable of longitudinal displacement in opposite directions comprising: a base; vertical supporting frame means fixed at one end thereof to said base; carrier means slidably mounted to said supporting frame means at the other end thereof; platform means mounted to said carrier means for supporting a patient and including a head panel, a back panel, a trunk panel connected to said carrier means along the side edges of said trunk panel and at least one leg panel, said panels being serially connected; hydraulic drive means including at least one hydraulic cylinder fixedly mounted on the vertical supporting frame means at said other end thereof and having a piston member connected to said carrier means for slidably displacing in the longitudinal direction said carrier means relative to said supporting frame means; the longitudinal displacement of the carrier means being such that all points on the platform means have at one time or another a vertical axis which clears the vertical supporting frame means thereby permitting an examination of a patient positioned on said platform means without moving the patient during the examination and tilting means in said carrier means for pivotably moving said platform means relative to said carrier means.
 2. A surgical and examination table structure capable of longitudinal displacement in opposite directions comprising: a base; vertical supporting frame means fixed at one end thereof to said base including vertically upstanding housing means, a coupling member pivotably connected to the upper end of said housing means and a plate means pivotably connected to the coupling member; carrier means slidably mounted to said supporting frame means at the other end thereof; platform means mounted to said carrier means for supporting a patient and including a head panel, a back panel, a trunk panel and at least one leg panel, said panels being serially connected; and hydraulic drive means supported by said plate means including at least one hydraulic cylinder fixedly mounted on the vertical supporting frame means at said other end thereof and having a piston member connected to said carrier means for slidably displacing in the longitudinal direction said carrier means relative to said supporting frame means; the longitudinal displacement of the carrier means being such that all points on the platform means have at one time or another a vertical axis which clears the vertical supporting frame means thereby permitting an examination of a patient positioned on said platform means without moving the patient during the examination.
 3. A table structure as defined in claim 2 further comprising hydraulic drive means mounted between said housing means and said coupling member for causing transverse pivotal movement of said platform means relative to the longitudinal plane thereof.
 4. A table structure as defined in claim 2 further comprising hydraulic drive means mounted between said housing means and said plate means for causing longitudinal pivotal movement of said platform means relative to said housing means.
 5. A table structure as defined in claim 2 wherein said drive means consist of a pair of hydraulic cylinder and piston units respectively disposed along each side edge of said trunk panel; the cylinders of said unit being attached to said plate means; the pistons of said units being fixed to said side edges whereby the introduction of pressurized fluid in said cylinders causes the longitudinal displacement of said side edges relative to said cylinders.
 6. A table structure as defined in claim 2 wherein said vertically upstanding housing means include first and second hollow housings telescopically received in one another, and hydraulic drive means mounted in said housings for lowering and raising said platform means.
 7. A table structure as defined in claim 1 wherein said tilting means include two elongated housings mounted respectively beneath the longitudinal edges of said trunk panel; each housing including a bottom wall and opposite side walls; an elongated drive plunger longitudinally displaceable in each housing centrally thereof; hydrAulic drive means in each housing for displacing said plunger therein; a pair of elongated linking members respectively mounted in each housing on opposite sides of said drive plunger, each linking member being pivotally mounted at one end thereof to a transverse axis secured to an adjacent side wall of said housing, the transverse axes being parallel and longitudinally spaced in said housing; each of said linking members being provided with an elongated curved slot; said plunger including on each side wall thereof a projection extending into an associated slot in said linking members; plate means extending longitudinally over said housing and having one end pivotally connected to one linking member at the end thereof opposite to the end pivotally mounted to a side wall of the housing and having the other end pivotally connected to the other linking member at the end thereof opposite the end pivotally mounted to the side wall of the housing; said slots being shaped whereby the longitudinal displacement of the plunger into the housing by said hydraulic drive means and the resulting travel of said projection in said slots cause the following positions: a first position where a first linking member is pivotally inclined with respect to the plane of the housing; a second position where both linking members are received in the same plane as the plane of the housing and the plunger; and a third position where the other linking member is pivotally inclined with respect to the plane of said housing and in opposite direction relative to the first position.
 8. A surgical and examination table structure capable of longitudinal displacement in opposite directions comprising: a base; vertical supporting frame means fixed at one end thereof to said base; carrier means slidably mounted to said supporting frame means at the other end thereof; platform means mounted to said carrier means for supporting a patient and including a head panel, a back panel, a trunk panel and at least one leg panel, each trunk panel including along each longitudinal side edge thereof means for articulating a respective leg panel thereto; each said articulating means including an elongated housing secured to said trunk panel along said side edge; a pair of spaced parallel transverse axes mounted at opposite ends of the housing; sprocket means mounted on each said axis; chain means entrained around said sprocket means, said chain means defining opposite intermediate strands extending between said sprocket means; toothed wheel means mounted on a first of said transverse axes; hydraulic drive means mounted in said housing and including a cylinder and piston, said piston having one end received in said cylinder and the other end fixed to one of the intermediate strands, a third transverse axis transversely mounted to said housing in the vicinity of said first transverse axis and adapted to receive thereon a toothed portion of said leg panel for meshing engagement with said toothed wheel means whereby torque received on said first transverse axis through actuation of said chain means by said hydraulic drive means is transmitted from said toothed wheel means to the toothed portion of the leg panel to thereby cause pivotal movement of the leg panel relative to the trunk panel, said panels being serially connected; and hydraulic drive means including at least one hydraulic cylinder fixedly mounted on the vertical supporting frame means at said other end thereof and having a piston member connected to said carrier means for slidably displacing in the longitudinal direction said carrier means relative to said supporting frame means; the longitudinal displacement of the carrier means being such that all points on the platform means have at one time or another a vertical axis which clears the vertical supporting frame means thereby permitting an examination of a patient positioned on said platform means without moving the patient during the examination.
 9. A table structure as defined in claim 8 further comprising second articUlating means mounted in each longitudinal side edge of said back panel for causing pivotal movement of said back panel relative to said trunk panel; each said second articulating means including: an elongated housing secured to said longitudinal side edge of said back panel; a pair of spaced parallel transverse axes mounted at opposite ends of said housing; sprocket means mounted on each said axis; chain means entrained around said sprocket means, said chain means defining opposite intermediate strands extending between said sprocket means; toothed wheel means mounted on a first of said transverse axes; hydraulic drive means mounted in said housing and including a cylinder and a piston, said piston having one end received in said cylinder and the other end fixed to one of said intermediate strands; a third transverse axis transversely mounted to said housing in the vicinity of said first transverse axis; each elongated housing of said first articulating means including a block fixedly secured to said housing of said articulating means adjacent a second of said pair of transverse axes of said first articulating means; said block provided thereon with a toothed portion to be meshed with the toothed wheel means of the second articulating means in said back panel whereby actuation of the drive means of the second articulating means in said back panel causes the pivotal movement of the back panel relative to the trunk panel.
 10. In a surgical table structure having platform means including at least a back panel, a trunk panel, and one leg panel, a device for articulating a first panel relative to a second panel comprising, in combination: at least one elongated housing secured to a first panel of said platform means; a pair of spaced parallel transverse axes mounted at opposite ends of said housing; sprocket means mounted on each said axis; chain means entrained around said sprocket means, said chain means defining opposite intermediate strands extending between said sprocket means; toothed wheel means mounted on a first of said transverse axes; hydraulic drive means mounted in said housing and including a cylinder and a piston, said piston having one end received in said cylinder and the other end fixed to one of said intermediate strands; a third transverse axis transversely mounted to said housing in the vicinity of said first transverse axis and adapted to pivotally receive thereon a toothed portion of said second panel of said platform means for meshing engagement with said toothed wheel means whereby torque received on said first transverse axis through actuation of said chain means by said hydraulic drive means is transmitted from said toothed wheel means to the toothed portion of the second panel to thereby cause pivotal movement of the second panel relative to the first panel.
 11. In a surgical table structure, as defined in claim 10, said first panel is said trunk panel and said second panel is a leg panel.
 12. In a surgical table structure, as defined in claim 11, a second similarly constructed articulating device provided in said back panel; the elongated housing of the articulating device in said trunk panel including a block fixedly secured to said housing adjacent the second of said pair of spaced transverse axes; said block having thereon a toothed portion to be meshed with the toothed wheel means of the second articulating device in said back panel whereby actuation of the drive means of the second articulating device in the back panel causes pivotal movement of the back panel relative to trunk panel, and actuation of the drive means of the articulating device in the trunk panel causes pivotal movement of the leg panel relative to the trunk panel.
 13. In a surgical table structure having a trunk panel, vertical supporting frame means and carrier means slidably mounted to the supporting frame means, a mechanism for tilting the trunk panel in opposite directions with respect to the carrier means comprising: at least one elongated housing mounTed in the carrier means and including a bottom wall and opposite side walls; an elongate drive plunger longitudinally displaceable in said housing centrally thereof; drive means for displacing said plunger in said housing; a pair of elongate linking members respectively mounted in said housing on opposite sides of said drive plunger, each linking member being pivotally mounted at one end thereof to a transverse axis secured to an adjacent side wall of said housing, the transverse axes being parallel and longitudinally spaced in said housing; each of said linking members being provided with an elongated curved slot; said plunger including on each side wall thereof a projection means extending into an associated slot of said linking members; plate means extending longitudinally over said housing and having one end pivotally connected to one linking member at the end thereof opposite to the end pivotally mounted to a side wall of the housing and having the other end pivotally connected to the other linking member at the end thereof opposite the end pivotally mounted to the side wall of the housing; said slots being shaped whereby the longitudinal displacement of the plunger in said housing by said drive means and the resulting travel of said projection means in said slots cause the following positions: a first position where a first linking member is pivotally inclined with respect to the plane of the housing; a second position where both linking members are received in the same plane as the plane of the housing and the plunger; and a third position where the other linking member is pivotally inclined with respect to the plane of said housing and in opposite direction relative to the first position. 